Long-term outcomes of transobturator tension-free vaginal tapes as secondary continence procedures.
- Resource Type
- Article
- Authors
- Abdel-Fattah, Mohamed; Cao, Gabriel; Mostafa, Alyaa
- Source
- World Journal of Urology. Jul2017, Vol. 35 Issue 7, p1141-1148. 8p.
- Subject
- *ADVERSE health care events
*DISEASES in women
*SECONDARY analysis
*FOLLOW-up studies (Medicine)
TREATMENT of urinary stress incontinence
- Language
- ISSN
- 0724-4983
Purpose: To assess the long-term patient-reported outcomes following TO-TVT as a secondary continence procedure in women with recurrent stress urinary incontinence (R-SUI). Methods: A secondary analysis of the 9-year follow-up of the E-TOT study was performed: 341 women with predominant SUI symptoms were randomised to undergo either Inside-out or Outside-in TO-TVT between April 2005 and April 2007. Forty-six women had R-SUI following previously failed continence surgery at time of randomisation and are the basis of this analysis as a one single cohort. Primary outcome was the patient-reported success rate defined as very/much improved on Patient's Global Impression of Improvement (PGI-I). Secondary outcomes included late adverse events and impact on women's quality of life and sexual function. Statistical analysis was performed using SPSS version 23. Results: Sixty-three per cent completed the 9-year follow-up. The success based on the PGI-I was 62.1% with no significant difference between groups (OR 5.33; 95% CI 1.03, 27.76; p = 0.094). Clinically significant improvement in QoL was found in 84.2%. Adverse events included vaginal erosions ( n = 3) and groin pain ( n = 2). The small sample size is a limitation in this study; nevertheless, this is one of the largest cohorts reported for women with R-SUI and the first to report the long-term outcomes of TO-TVT as a secondary continence procedure. Conclusions: TO-TVT operations are associated with good patient-reported success rates (62%) in women with previous failed continence surgery with up to 9-years follow-up. There is a non-significant trend towards better outcomes with the inside-out TO-TVT. [ABSTRACT FROM AUTHOR]